Patients With Existing Pressure Ulcers Admitted to Acute Care

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Abstract
Purpose This study describes the characteristics of patients with pressure ulcers present on admission to the hospital and predictors of pressure ulcer presence and severity. Design Prospective cohort study. Setting and subjects Adults (n = 267) admitted to a Pacific Basin military hospital who were expected to stay more than 24 hours. Instruments Braden scale, portable vital sign machine, and pulse oximeter. Methods Pressure ulcer risk was evaluated and skin inspection was performed. Demographic, physiologic, and laboratory data were obtained. Medical history and patient acuity were recorded. Results Thirty-four of 267 subjects (12.8%) had a pressure ulcer. Most were male and white. Their mean age was 65.7 years; mean albumin level, 2.9 g/dL; mean hematocrit level, 31.9 vol%; mean oxygen saturation, 95.3 mm Hg; and mean hemoglobin level, 10.7 g/dL. The mean Braden scale score for subjects without ulcers on admission was 19.7, and it was 15.9 for those with ulcers (P < .05). Analysis of variance showed that subjects with pressure ulcers had a significantly lower albumin level, total lymphocyte count, hematocrit level, and hemoglobin level. These subjects were significantly older and had a longer hospital length of stay. Regression showed that albumin level, oxygen saturation, and length of stay (P < .01) accounted for 11.3% of the variance of pressure ulcer presence and that albumin level and length of stay (P < .001) accounted for 11.2% of the variance in ulcer severity. Conclusions Poorer nutritional status and decreased oxygen perfusion were predictors of pressure ulcers on admission. Nutrition and length of stay were predictors of ulcer severity. Further research is warranted.